TMA Legislative News Hotline: Tuesday, May 28, 2013

3 Days Remaining of 2013 Legislature


Within less than an hour after wrapping up the final details of the 2013 legislative session, Gov. Rick Perry called legislators back into a special session, starting at 6 pm Monday. At this point, the special session addresses redistricting only. The governor sets the agenda. Lawmakers need to decide on the state’s political maps used to elect Texas House and Senate members and members of Congress. The House is back at work today. Senators reconvene Thursday.  Stay tuned.


After six years of hard work, TMA’s Silent PPO bill was signed into law Saturday by Governor Perry. The new law goes into effect Sept. 1, 2013. TMA President, Stephen L. Brotherton, MD, sent out the following statement Sunday:

“Texas physicians applaud Gov. Rick Perry for taking a bold step to rein in companies that sell, lease, or share physician-contracted discounts without the physician’s knowledge or consent. These practices, known as ‘silent PPOs,’ mislead patients and cause needless costly hassles for physicians who fall victim to them. The legislation, Senate Bill 822 by Sen. Charles Schwertner, MD (R-Georgetown), and Rep. Craig Eiland (D-Galveston) was TMA’s No. 1 priority for establishing fair and transparent insurance markets for patients, employers, and physicians this session. Thanks to Senator Schwertner and Representative Eiland, Texas now has a new law that will help identify these companies and subject them to Texas Department of Insurance oversight, and that sets the ground rules for getting a physician’s express authority to make a contract available to a payer. Regulating these companies was one of many important issues outlined in TMA’s Healthy Vision 2020 to improve Texas’ health care system.”

Waiting on the governor’s desk is a similar bill that would stop Medicaid HMOs from selling or trading your discounted rates.


Over the weekend, legislators sent a $197 billion budget bill for 2014-15 to the governor’s desk. The budget increases spending for mental health and substance abuse services, and women’s health services. It also restores funding for the state’s Physicians Education Loan Repayment Program and takes steps to reverse the 2011 cuts made to graduate medical education funding. 


Lawmakers approved a host of bills critical to TMA’s legislative agenda over the weekend. House and Senate members had to resolve differences between the House and Senate versions of the bills in conference committees. The good news is our bills were resolved and now go to the governor’s desk for signature. These are the bills:

  • Senate Bill 644 by Sen. Joan Huffman (R-Houston) and Rep. John Zerwas, MD (R-Simonton), requires the Texas Department of Insurance (TDI) to appoint a stakeholder workgroup to design a standard prescription drug prior-authorization form applicable across all payers, including Medicaid and the Children’s Health Insurance Program (CHIP).
  • Senate Bill 1216 by Sen. Kevin Eltife (R-Tyler) and Rep. Sarah Davis (R-West University Place) requires TDI to appoint a stakeholder workgroup to design a standard request form for prior authorization of health care services applicable to all payers.
  • House Bill 1803 by Rep. Bill Callegari (R-Katy) and Senator Huffman would start the renewal of physicians’ Department of Public Safety (DPS) Controlled Substances Registration with their online medical license renewal at the Texas Medical Board.  A provision was added that defines pain management as the practice of medicine.
  • House Bill 500 by Rep. Harvey Hiderbran (R-Kerrville) and Sen. Glenn Hegar (R-Katy) establishes a $1 million state franchise tax deduction for small businesses. It could give many Texas physicians needed relief from the state’s franchise tax. TMA added an amendment to the bill that allows physicians to deduct vaccine purchase cost from taxable revenues.
  • Senate Bill 1150 by Sen. Chuy Hinojosa (D-McAllen) and Rep. Bobby Guerra (R-McAllen) requires the Texas Health and Human Services Commission (HHSC) to implement a “provider protection plan” under Medicaid HMOs or other arrangements and incorporate the plan into the contracts between HHSC and the plans. Plans must pay claims properly and promptly. The bill imposes penalties on plans that engage in low-pay, slow-pay, no-pay activity.
  • Senate Bill 7 by Sen. Jane Nelson (R-Flower Mound) and Rep. Richard Raymond (D-Laredo) aims to save money in the Medicaid program by expanding Medicaid HMOs to people with intellectual and development disabilities and to nursing home residents.
  • Senate Bill 227 by Sen. Tommy Williams (R-The Woodlands) and Representative Zerwas would allow physicians to dispense aesthetic pharmaceuticals in excess of the patient’s immediate needs without a pharmacist license. Drugs include bimatoprost for growing eyelashes; hydroquinone, a skin whitener; retinoid for improving skin; and metronidazole to treat rosacea.
  • Senate Bill 646 by Sen. Robert Deuell, MD (R-Greenville), and Rep. Elliot Naishtat (D-Austin) amends current law relating to court-ordered outpatient mental health services.
  • Senate Bill 1643 by Senator Williams and Rep. Carol Alvarado (D-Houston) improves access to prescription information by physicians. It allows them to delegate information retrieval to a nurse and allows for connection to DPS through a health information exchange, as long as proper security measures are in place to protect against disclosure to unauthorized individuals. The bill also allows physicians to include that information in a patient’s medical records, but that information would be subject to any applicable state or federal confidentiality or privacy laws.  


Governor Perry appointed a new commissioner to run TDI. The new commissioner, Julia Rathgeber, was previously deputy chief of staff and policy director to Lt. Gov. David Dewhurst. We look forward to working with her. 


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